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'A Huge Deal': Biden Rebuffs Georgia's Medicaid Work Requirement--Last in US
"By ending work requirements in many states, Biden is erasing one of Trump's cruelest legacies."
Dec 24, 2021
After the White House on Thursday rejected a proposal to impose work requirements on Medicaid recipients in Georgia--the last state with a federal waiver permitting such restrictions--President Joe Biden received praise for "quietly erasing" one of his predecessor's "cruelest legacies."
"The announcement from the Centers for Medicare & Medicaid Services, delivered in a 79-page letter to Georgia's health agency, also reversed a federal waiver allowing the state to charge premiums for the health insurance program for the poor," according to the New York Times.
The Times reported:
Georgia had not yet imposed the proposed work requirements--which limited Medicaid eligibility to those who work at least 80 hours a month--but it could have started the restrictions as early as next week, according to correspondence between the state and federal health agencies.
The premiums that Georgia proposed had also not been enacted. The Medicaid agency said that it was revoking the authority to charge the premiums because those fees "can present a barrier to coverage" and worsen healthcare inequality.
Biden's move dealt "a critical blow to the already reeling effort to attach work requirements to Medicaid," the newspaper noted. "The movement by more than a dozen states managed in practice to enact work requirements in only a few--and only for a short time--as it faced court setbacks, a pandemic, and a new administration that has steadily dismantled such initiatives."
Washington Post columnist Greg Sargent called Biden's elimination of Georgia's Medicaid work requirements--the last remaining proposal of its kind in the U.S.--"a huge deal."
In 2018, Seema Verma, then-director of the Centers for Medicare & Medicaid Services under former President Donald Trump, issued guidance allowing states to apply for a waiver to significantly alter eligibility requirements for Medicaid, a Great Society-era program on which 76 million low-income adults, people with disabilities, and children rely for health insurance.
Nearly 20 Republican-led states quickly jumped at the opportunity to take healthcare away from poor and vulnerable Americans, and the Trump administration ultimately approved policies to deny Medicaid coverage to people who didn't comply with strict work requirements in 13 states.
The Biden White House in February invalidated the previous administration's guidance allowing states to apply for Medicaid eligibility restriction waivers and notified states that had already been given permission to impose work requirements that the policies would soon be reversed due to the detrimental impact of coverage loss on Medicaid recipients, particularly during the Covid-19 pandemic, as Common Dreams reported at the time.
After the Biden administration in March told Medicaid officials in New Hampshire and Arkansas--which was the first and only state to fully implement Medicaid work requirements, taking healthcare away from at least 18,000 people over a period of several months in 2018--that approval for such policies had been revoked, progressives urged the White House to forge ahead with its plan to withdraw all remaining Medicaid work requirements nationwide, which it has done.
"This is a genuine achievement, in both symbolic and practical terms," Sargent and Paul Waldman wrote Friday of Biden's successful neutering of Trump's signature attack on healthcare.
Biden's rejection of Georgia's proposal "was effectively the last nail in the coffin of Trump's zombie attempt to make Medicaid more cumbersome and bureaucratic, in hopes of knocking as many people off health coverage as possible," argued the pair.
According to Sargent and Waldman:
Trump's effort to impose Medicaid work requirements was part of a much larger campaign to undermine and roll back our country's fitful advance toward universal healthcare. This constituted an even broader legacy of cruelty, and arguably outright betrayal.
That's because Trump campaigned in 2016 as a corrective to Paul Ryan-style Republicans who had treated destroying the social safety net as a quasi-religious calling. Trump vowed that "everybody's got to be covered," and insisted no one would die on the street, uninsured.
Once in office, however, "Trump embraced GOP anti-safety-net zealotry by going all in on the Republican effort to destroy the Affordable Care Act," they continued. "That culminated in the 2017 repeal attempt, which fortunately failed. Stymied in that effort, which would have taken coverage away from millions on the ACA's Medicaid expansion, Trump sought to weaken the safety net via other administrative means, such as these Medicaid work requirements."
"And so, in erasing those requirements," Sargent and Waldman added, "Biden is also erasing a larger hangover of Trumpian cruelty."
Sargent and Waldman noted that "the same ACA that Trump tried to destroy is expanding" because the American Rescue Plan signed by Biden in March enhanced ACA subsidies and widened eligibility for them. However, they pointed out, "the ACA expansion in the rescue package expires at the end of next year."
Although the vast majority of congressional Democrats want to extend the ACA expansion by passing the Build Back Better Act, right-wing Democratic Sen. Joe Manchin's (W. Va.) opposition to the legislation puts beefed-up healthcare subsidies at risk, hurting millions of low-income Americans and potentially jeopardizing Democrats' electoral performance.
"If Democrats aren't able to extend it, millions of people will get notice of huge premium increases right before the midterm election," Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, told Sargent and Waldman.
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Biden Urged to Withdraw All Medicaid Work Requirements Approved by Trump
Policies to "take Medicaid coverage away from people who don't comply with stringent work requirements... are deeply harmful."
Apr 05, 2021
While the White House in recent weeks has taken steps to overturn a Trump-era initiative enabling states to restrict Medicaid eligibility by imposing punitive work requirements, healthcare advocates on Monday urged President Joe Biden to rescind all Medicaid work requirement policies approved by his predecessor.
"Uninsurance rates among people subject to the work requirement rose, but their employment rates didn't."
--Jennifer Wagner, CBPP
In 2018, Seema Verma, then-director of the Centers for Medicare and Medicaid Services under former President Donald Trump, issued guidance allowing states to apply for a waiver to significantly alter eligibility requirements for Medicaid, a Great Society-era program on which more than 72 million low-income adults, people with disabilities, and children rely for health insurance.
Several Republican-led states quickly jumped at the offer to strip healthcare away from poor and vulnerable Americans, and the Trump administration ultimately approved policies to "take Medicaid coverage away from people who don't comply with stringent work requirements" in 13 states, as Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities (CBPP), noted Monday in a blog post.
While litigation and the coronavirus pandemic have put the implementation of work requirement policies "on hold," Wagner stressed that "taking coverage away from enrollees or otherwise conditioning coverage on meeting a work requirement doesn't further Medicaid's purposes," which exists to provide healthcare to the impoverished. "Accordingly," she added, "the Biden administration should now withdraw all of the previous approvals."
The White House in February invalidated the previous administration's guidance allowing states to apply for Medicaid eligibility restriction waivers and notified states that had already been given permission to impose work requirements that the policies would soon be reversed due to the detrimental impact of coverage loss on Medicaid recipients, particularly during the pandemic, as Common Dreams reported at the time.
Last month, the Biden administration told Medicaid officials in New Hampshire and Arkansas--which was the first and only state to fully implement Medicaid work requirements, taking healthcare away from at least 18,000 people over a period of several months in 2018--that approval for their work requirement policies had been rescinded.
While "Georgia, Indiana, Nebraska, Ohio, South Carolina, and Utah have objected" to Biden's efforts to dismantle Medicaid work requirements, Wagner reiterated that "the administration should nevertheless continue with its plan."
"These policies inevitably lead to eligible enrollees losing coverage--work requirements can't be fixed."
--Wagner
Wagner continued: "The Trump administration claimed that requiring work or other activities as a condition of coverage would 'improve beneficiaries' health,' ignoring evidence from other programs suggesting these restrictions would significantly harm Medicaid enrollees. After states began implementing these policies, their experiences confirmed the harmful effects of work requirements."
Citing a new analysis from the Department of Health and Human Services, Wagner wrote that "these policies are deeply harmful to Medicaid enrollees and confirms that they don't promote Medicaid's objectives."
Referring to the 18,000 Arkansas residents who lost Medicaid coverage in 2018, Wagner said that "uninsurance rates among people subject to the work requirement rose, but their employment rates didn't."
Arkansans "who lost coverage were more likely to have chronic conditions, and many had difficulty paying their medical bills and accessing healthcare and medications," she continued. "Data from New Hampshire and Michigan also show a significant loss of coverage would have occurred if the states' work requirement policies had been implemented, largely due to enrollees' limited awareness of the policies and challenges in reporting compliance."
"The evidence of the detrimental impact of work requirements from Arkansas, New Hampshire, and Michigan demonstrates that other state policies would face the same challenges and harmful consequences," she added. "All policies that take away coverage from people not meeting work requirements are marred by complex rules about who is exempt and what activities count, challenges communicating with enrollees, and burdensome paperwork and reporting requirements. These policies inevitably lead to eligible enrollees losing coverage--work requirements can't be fixed."
According to Wagner, "There's nothing left to demonstrate by letting more states take risks with Medicaid enrollees' health. The Centers for Medicare and Medicaid Services should withdraw all waiver authority for policies that take coverage away from people not meeting work requirements or otherwise condition coverage or benefits on meeting them and make clear that these policies won't be allowed in Medicaid."
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Biden Plans to Rescind Medicaid Work Requirements, Targeting One of Most 'Cruel' Policies of Trump Era
"We celebrate this win—this win that we made happen—even while mourning the loss of every person who relied on Medicaid and didn't survive the calamity of Trump's disastrous administration."
Feb 11, 2021
The Biden administration on Friday is expected to begin the process of rescinding a Trump policy allowing states to impose punitive work requirements on Medicaid recipients, a move celebrated as a crucial step toward reversing one of the former president's most vicious attacks on the poor and vulnerable.
According to the Washington Post, which obtained a draft of the Biden administration's plan, federal health officials on Friday "will withdraw their predecessors' invitation to states to apply for approval to impose such work requirements and will notify 10 states granted permission that it is about to be retracted."
The brainchild of Seema Verma, head of the Centers for Medicare and Medicaid Services under Trump, the work requirements initiative began in 2018 with guidance allowing states to apply for a waiver to significantly alter Medicaid eligibility requirements. Several Republican-led states quickly jumped at the offer; Arkansas, the first and only state to fully implement Medicaid work requirements, threw at least 18,000 people off the healthcare program over a period of several months in 2018.
While the destructive efforts of Arkansas and other states were largely stymied by federal court interventions, the Biden administration's plan to roll back the Trump work requirements guidance was applauded as key progress toward definitively ending one of the former president's most prominent efforts to strip healthcare from low-income people.
"We worked so very hard for this," Matthew Cortland, an attorney and disability rights activist, said of the effort to defeat the work requirements. "We celebrate this win--this win that we made happen--even while mourning the loss of every person who relied on Medicaid and didn't survive the calamity of Trump's disastrous administration."
Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, argued in a series of tweets late Thursday that "the Trump administration's Medicaid work requirement policy was never really about work," noting that "93% of Medicaid beneficiaries who are not on Medicare or SSI are already working, taking care of a family member, going to school, or not working due to illness."
"Medicaid work requirements have roots in the ideology that healthcare under Medicaid should be considered welfare for the deserving poor rather than a right," Levitt added.
In a last-ditch effort to preserve the work requirements policy during the final weeks of the Trump administration, Verma "asked states to sign contracts that would establish a lengthy process for unwinding work requirements and other conservative changes to their Medicaid programs," Politico reported Thursday.
"Medicaid experts have questioned whether those contracts are legally enforceable," the outlet noted.
The Biden administration's plan--which points to the ongoing coronavirus pandemic as a major reason to end the Trump era guidance--will come over a month before the U.S. Supreme Court is set to hear a case on the legality of the Medicaid work requirements. According to the the Wall Street Journal, Biden health officials are "expected to move quickly to end work requirements in Medicaid... because doing so could moot" the Supreme Court case.
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As Pandemic Rages, Trump Admin. Approves Tennessee's "Reckless" Plan to Slash Medicaid
The eleventh-hour safety net attack is being met with outrage from advocates of strengthening the healthcare program.
Jan 09, 2021
Healthcare advocates are criticizing the Trump administration's approval--amid overwhelming opposition, a global pandemic, and as the number of uninsured Americans grows--of Tennessee's plan to overhaul funding of its Medicaid program, calling the decision "reckless" and "irresponsible."
Joan Alker, executive director of the Georgetown Center for Children and Families, called it "a radical waiver that puts Tennessee's Medicaid beneficiaries at risk."
The state's Medicaid program, TennCare, covers 1.5 million people, or about one in five of the state's residents. The proposal would "fundamentally" transform how TennCare is managed and funded, The Tennessean reported. When Republican Gov. Bill Lee rolled out the plan in fall, the outlet added, the state received 1,800 written comments, of which just 11 were in support.
Kaiser Health News reported:
With just a dozen days left in power, the Trump administration on Friday approved a radically different Medicaid financing system in Tennessee that for the first time would give the state broader authority in running the health insurance program for the poor in exchange for capping its annual federal funding.
The approval is a 10-year "experiment." Instead of the open-ended federal funding that rises with higher enrollment and health costs, Tennessee will instead get an annual block grant. The approach has been pushed for decades by conservatives who say states too often chafe under strict federal guidelines about enrollment and coverage and can find ways to provide care more efficiently.
But under the agreement, Tennessee's annual funding cap will increase if enrollment grows. What's different is that unlike other states, federal Medicaid funding in Tennessee won't automatically keep up with rising per-person Medicaid expenses.
The approval, however, faces an uncertain future because the incoming Biden administration is likely to oppose such a move. But to unravel it, officials would need to set up a review that includes a public hearing.
The Centers for Medicare and Medicaid Services (CMS) announced the approval Friday. "It's no exaggeration to say that this carefully crafted demonstration could be a national model moving forward," said CMS Administrator Seema Verma--a Trump appointed official who's pushed attacks on Medicaid and has been described as "the architect of Indiana's punitive restrictions on Medicaid patients."
Michele Johnson, executive director of the Tennessee Justice Center, said in response to the approval that "no other state has sought a block grant, and for good reason," and warned of its impacts to those "in nursing homes, those struggling with mental illness, diabetes, cancer, and countless other complex conditions."
"Tennessee is one of a handful of states still denying Medicaid to its working uninsured, and the block grant is just another example of putting politics ahead of healthcare during this pandemic," said Johnson. "It's a political gimmick that jeopardizes access to healthcare for hundreds of thousands of Tennesseans by creating a state budget booby trap."
"State officials have an abysmal record of mismanaging programs that help those in need. The block grant will allow these same state officials to inflict further damage on Tennessee's healthcare system," she said.
The approval also drew outrage from a coalition of 21 patient and consumer groups including the American Lung Association, American Cancer Society Cancer Action Network, and National Alliance on Mental Illness. They called the plan's approval "a reckless move that would reduce Tennesseans' ability to get needed healthcare" and urged the incoming Biden administration to halt its implementation.
"The approval specifically includes authority to limit prescription drug coverage, a dangerous proposal for patients."
--21 Patient Groups"Our organizations have clearly and repeatedly voiced our deep concerns with Tennessee's proposal, as well as our strong opposition to block grants in Medicaid in general," the groups said Friday in a joint statement. "Per capita caps and block grants are designed to cap or limit the amount of federal funding provided to states, forcing them to either make up the difference with their own funds or make cuts to their programs reducing access to care for the patients we represent."
Such cuts, they warned, "will likely result in enrollment limits, benefit reductions, reductions in provider payments, or increased out-of-pocket cost-sharing for Medicaid enrollees. The approval specifically includes authority to limit prescription drug coverage, a dangerous proposal for patients."
Referencing the coronavirus pandemic, the groups added, "It is irresponsible to approve this waiver during this public health crisis, and especially to do so for an unprecedented 10-year period." Implementation of the plan stands to "limit Tennessee's flexibility in responding to recessions, pandemics, new treatments, and natural disasters," and thus "moves in the opposite direction of the lessons learned from 2020."
The Tennessean further noted:
The block grant approval, negotiated over about a year with the Centers for Medicare and Medicaid Services, still must get final approval from state lawmakers before it can be implemented. Lee now intends to present a joint resolution on the plan for the General Assembly's "immediate consideration," according to a news release.
The Tennessee Justice Center is urging its supporters to pressure lawmakers to block the plan.
"We are not surprised but are unsettled by this eleventh-hour action by the federal government during the height of the pandemic," said Jane Perkins, legal director for the National Health Law Program. "The approval raises so many issues," she said, "from the process the government used to approve this project to the specifics of how the government has cut into the healthcare safety net. Our legal team is investigating the enforcement and litigation options at this time."
Rep. Frank Pallone (D-N.J.), chair of the House Energy and Commerce Committee, which has jurisdiction over Medicaid, also sounded alarm.
"This is an illegal move that could threaten access to healthcare for vulnerable people in the middle of a pandemic," Pallone tweeted Friday. He also expressed hope the incoming Biden administration would "move quickly to roll back this harmful policy as soon as possible."
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'Shameless Stunt': Trump Reportedly Attempting to Raid Medicare Trust Fund to Pay for Drug Discount Cards With His Name on Them
"There it is: Trump wants to steal billions from Medicare to pay for an illegal voter bribery scheme weeks before the election."
Oct 09, 2020
Less than a month away from the November election, Trump administration officials are reportedly rushing to implement the president's recent proposal to send $200 prescription drug discount cards to nearly 40 million Medicare recipients--an $8 billion plan that would be financed by dipping into the Medicare trust fund.
Politico reported Thursday that the administration is "seeking to finalize the plan as soon as Friday and send letters to 39 million Medicare beneficiaries next week, informing seniors of Trump's new effort to lower their drug costs, although many seniors would not receive the actual cards until after the election." While the design of the cards has yet to be finalized, officials are reportedly discussing ways to put Trump's name on them.
"It's a shameless stunt that steals billions from Medicare in order to fund a legally dubious scheme that's clearly intended to benefit President Trump's campaign right before Election Day."
--Rep. Frank Pallone Jr.
The plan would cost $7.9 billion, according to Politico, with $19 million going toward letters touting the initiative, which advocacy groups and Democratic lawmakers are denouncing as an obvious and potentially unlawful campaign ploy that would provide little relief for the millions impacted by obscenely high drug prices.
"There it is: Trump wants to steal billions from Medicare to pay for an illegal voter bribery scheme weeks before the election," tweeted Rep. Bill Pascrell Jr. (D-N.J.).
Rep. Frank Pallone Jr. (D-N.J.), chairman of the House Energy and Commerce Committee, echoed Pascrell in a statement to Politico. "It's a shameless stunt that steals billions from Medicare in order to fund a legally dubious scheme that's clearly intended to benefit President Trump's campaign right before Election Day," said Pallone.
In a speech on healthcare in Charlotte, North Carolina late last month, Trump proclaimed that his administration would "in the coming weeks" be mailing out $200 medicine discount cards to tens of millions of Medicare recipients, an announcement that reportedly caught some officials at the Department of Health and Human Services off guard.
"We don't need more PR stunts designed to distract us from the reality that President Trump has done more to help the drug corporations with big tax breaks than he has to help seniors struggling to afford medicine."
--Margarida Jorge, Lower Drug Prices Now
"Nobody's seen this before, these cards are incredible," said the president, who is badly trailing Democratic nominee Joe Biden among senior voters in recent polls. "Biden won't be doing this."
Politico reported that Seema Verma, administrator of the Centers for Medicare and Medicaid Services, is pressuring officials to have the plan ready to go before Election Day, heightening internal concerns that the discount cards are little more than an attempt to assist Trump's reelection campaign with taxpayer dollars.
"This is a solution in search of a problem and a bald play for votes in the form of money in pockets," one unnamed HHS official told Politico.
Margarida Jorge, campaign director for Lower Drug Prices Now, said in a statement that "sending $200 gift cards to seniors before the election is a poor substitute for continuing to let drug corporations jack up their medicine prices afterwards."
"Yet again, President Trump is trying to bribe his way to re-election," said Jorge. "Americans need serious reforms that check Pharma's power to charge whatever they want and to increase prices any time. We don't need more PR stunts designed to distract us from the reality that President Trump has done more to help the drug corporations with big tax breaks than he has to help seniors struggling to afford medicine."
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Denouncing Seema Verma's "Textbook Definition of Corruption," Jayapal Calls for Medicare Chief's Ouster
"She must resign or be removed."
Jul 17, 2020
Rep. Pramila Jayapal on Thursday called for the ouster of Medicare and Medicaid chief Seema Verma following a watchdog's report revealing that the administration official violated federal requirements in her management of over $6 million in contracts.
The report from inspector general at the Department of Health and Human Services, according to Jayapal (D-Wash.), added more evidence that "Verma has been using government money for her personal benefit" and showed that the Centers for Medicare and Medicaid Services administrator engaged in "the textbook definition of corruption."
For its audit, the OIG said it looked at three contracts for strategic communications services from June 2017 through April 2019 and found:
CMS allowed a subcontractor individual to perform inherently governmental functions, such as making managerial decisions and directing CMS employees. CMS also administered its strategic communications services contracts as personal services contracts. CMS officials exerted a level of control over the contractors' work that exceeded what is allowed under service contracts; in essence, CMS administered these contracts as if the services had been procured under CMS's statutory authority to contract for experts and consultants. Lastly, CMS did not comply with FAR [Federal Acquisition Regulation] requirements in managing contract deliverables and approving the use of a subcontractor, did not maintain complete working files for all three contracts, and paid some questionable costs.
The contacts, as Politico reported Thursday, "ultimately benefited GOP-aligned communications consultants." Or, as Esquire's Charles Pierce put it, the IG findings showed Verma "has been helping various Republican consultants get fat."
Government watchdog group Citizens for Responsibility and Ethics in Washington (CREW) responded to reporting on the inspector general's findings with a tweet Thursday saying, "Reports like this are exactly why we need independent IGs to conduct robust oversight."
Jayapal isn't alone in her call for Verma--an ally of Vice President Mike Pence and proponent of Medicaid privatization--to replaced.
The Washington congresswoman joined seven other House Democrats in a letter to President Donald Trump on Thursday, writing, "After a 15-month inspector general (IG) investigation, it has now been proven that Verma has consistently shown a lack of good judgement when it comes to responsible stewardship of taxpayer dollars."
"She has defied rules, skirted regulations, violated trust, misled Congress, and she must be replaced," the Democrats wrote in the letter, led by Rep. Joe Kennedy (D-Mass.).
"Besides arranging contracts with personal friends to raise her profile and thus misspending CMS dollars, the IG investigation identified additional hundreds of thousands of 'questionable costs' all associated with reckless spending," the letter added. "She has put the agency at risk of raud and abuse and therefore she has put the public in jeopardy."
Additional scrutiny came from Reps. Frank Pallone, Jr. (D-N.J.) and Carolyn Maloney (D-N.Y.) and Sens. Patty Murray (D-Wash) and Ron Wyden (D-Ore.), who said in a joint statement Thursday that over "the past year, our offices have been investigating Administrator Verma's use of millions of taxpayer dollars to retain high-end communications consultants to burnish her public profile."
The "report confirms that Administrator Verma and her top officials used contracts in violation of federal regulations and spent taxpayer funds inappropriately to retain these private consultants," the lawmakers continued, adding that their offices would soon release additional findings they claimed would "provide additional details on Administrator Verma's inappropriate use of private consultants for her personal benefit."
Verma, for her part, has rejected the IG's conclusions, calling them "unsubstantiated assumptions and incomplete analyses."
CREW's deputy director Donald Sherman, in a Thursday tweet, hinted at Trump's purge of inspectors general and the important role the watchdogs play in rooting out corruption.
"Inspectors general expose corruption like Verma's," he said. "That's why President Trump hates them so much."
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Cruelty 'Off the Charts' as Trump Blocks States From Expanding Medicaid in Response to Coronavirus
"Not even a global pandemic will stop dead-eyed right-wing extremists from trying to eviscerate the social safety net."
Mar 13, 2020
As states across the U.S. struggle to contain the novel coronavirus and treat those who have been infected, the Trump administration is blocking state governments from expanding Medicaid coverage to ensure that vulnerable populations are able to receive necessary healthcare in the face of the rapidly spreading pandemic.
The Los Angeles Times reported Friday that "despite mounting pleas from California and other states, the Trump administration isn't allowing states to use Medicaid more freely to respond to the coronavirus crisis by expanding medical services."
"It isn't enough Trump and loyalists have catastrophically botched the response to this epidemic and lied about it. The admin is now blocking states from expanding medical services. Ghouls."
--Rep. Bill Pascrell
"In previous emergencies, including the 9/11 terrorist attacks, Hurricane Katrina, and the H1N1 flu outbreak, both Republican and Democratic administrations loosened Medicaid rules to empower states to meet surging needs," the Times noted. "But months into the current global disease outbreak, the White House and senior federal health officials haven't taken the necessary steps to give states simple pathways to fully leverage the mammoth safety net program to prevent a wider epidemic."
A number of factors have played into the Trump administration's refusal to allow states to expand Medicaid, according to the Times, including Trump's hesitance to declare a national emergency--which would allow states to more easily receive Medicaid expansion waivers--and the right-wing views of top federal health officials like Seema Verma, administrator of the Centers for Medicare and Medicaid Services.
Verma has been a driving force behind the Trump administration's effort to impose more punitive work requirements on Medicaid recipients and allow states to convert Medicaid funding into fixed block grants, a move that would could limit states' flexibility to respond to health and economic crises.
"Medicaid could be the nation's biggest public health responder, but it's such an object of ire in this administration," Sara Rosenbaum, a Medicaid expert at George Washington University, told the Times. "Their ideology is clouding their response to a crisis."
Dr. Abdul El-Sayed, former executive director of the Detroit Health Department, tweeted that "blocking states from using Medicaid to fight COVID-19 is asking them to fight the monster with one arm behind their back."
"This is just astounding," El-Sayed said of Trump's stonewalling.
Asked Thursday whether he would be willing to declare a national emergency over the coronavirus, Trump was non-commital and continued to downplay the threat posed by the pandemic, which has infected more than 1,600 people in the United States as of Friday morning.
"Well, we have things that I can do," Trump said. "We have very strong emergency powers under the Stafford Act... I have it memorized, practically, as to the powers in that act. And if I need to do something, I'll do it. I have the right to do a lot of things that people don't even know about."
"But, you know, look, we're in great shape," the president added.
Progressive advocacy group Social Security Works tweeted that "it is despicable for the Trump administration to block states from using Medicaid to respond."
"Public health must be the priority during the coronavirus crisis," the group added.
Rep. Bill Pascrell Jr. (D-N.Y.) also issued a scathing condemnation of the Trump White House in response to the Times reporting.
"It isn't enough Trump and loyalists have catastrophically botched the response to this epidemic and lied about it," Pascrell tweeted. "The admin is now blocking states from expanding medical services. Ghouls."
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Federal Appeals Court Strikes Down Trump's 'Work-or-Die' Medicaid Requirements in Arkansas
The ruling upheld a lower court decision, with a three-judge panel unanimously arguing Medicaid work requirements negate the purpose of the program.
Feb 13, 2020
Healthcare advocates on Friday applauded a federal appeals court decision striking down the Trump administration's Medicaid work requirements in Arkansas after a three-judge panel unanimously ruled that the proposed rule fundamentally disregarded the purpose of the safety net program.
Judge David Sentelle, a conservative Reagan appointee, handed down the ruling on behalf of the U.S. Court of Appeals for the D.C. Circuit, vehemently rejecting the administration's argument that requiring Medicaid recipients to work would make poor Arkansas residents more self-sufficient and reduce the need for the program.
"The Court recognized the tragic harm that these work requirements have caused people in Arkansas doing their best to get ahead."
--Kevin De Liban, Legal Aid of Arkansas
Medicaid, Sentelle wrote, "includes one primary purpose, which is providing healthcare coverage without any restriction geared to healthy outcomes, financial independence, or transition to commercial coverage."
Critics of the temporarily-imposed restrictions, which the Trump administration has adopted in 10 states but which have faced legal challenges and have been halted across the country, applauded the challenge to what disability rights advocate and attorney Matthew Cortland called "work-or-die requirements."
The ruling could portend similar challenges to other items on the healthcare agenda of President Donald Trump and Seema Verma, the administrator of the Centers for Medicare and Medicaid Services. Last month, Verma urged state Medicaid officials to reduce spending for the program by converting its funding into block grants.
"The appeals court decision makes clear that the [administration] cannot make up new objectives for the program and that the text of the law is clear that the central purpose of Medicaid is to provide coverage," wrote Joan Alker, executive director of the Center for Children and Families at Georgetown University. "This suggests that other harmful waiver policies which have the effect of limiting coverage (such as lockouts, limiting retroactive eligibility, premiums, etc.) may suffer a similar fate."
Under the rules, Medicaid recipients would be required to work or attend job training courses for at least 20 hours per week in order to qualify for health coverage.
A study by researchers at Harvard University last year showed that when the requirements were temporarily in effect in Arkansas before a lower court ruling halted them, nearly 20,000 residents lost their health coverage--while the employment rate also went down by 4%.
"Medicaid work requirements don't cause anybody to get work; they just lose their insurance," wrote political science professor Scott Lemieux at the time.
The federal appeals court slammed the Trump administration in its ruling for not considering the number of Arkansans who lost coverage under the requirements before they were struck down last year.
"The Court recognized the tragic harm that these work requirements have caused people in Arkansas doing their best to get ahead," Kevin De Liban, an attorney at Legal Aid of Arkansas, which challenged the requirements, told The Hill. "Now, more than two hundred thousand Arkansans on the program can rest easier knowing that they'll have healthcare when they need it."
The work requirements are currently only in effect in Michigan. The Arkansas decision makes it likely that the Trump administration may ask the U.S. Supreme Court to hear its case.
"We hope the federal government and the states will return to focusing on expanding coverage and access, so that everyone--regardless of economic status--can be healthy," said Sam Brooke, deputy legal director at the Southern Poverty Law Project.
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'Blatant Lie': Seema Verma Claims Trump Not Cutting Medicaid as He Pushes Plan Doing Just That
"Make no mistake: the Trump administration has spent the past two years actively dismantling Medicaid by fiat—after failing to gut it legislatively."
Feb 06, 2020
Healthcare advocates are calling out Centers for Medicare and Medicaid Services Administrator Seema Verma for claiming Thursday that the Trump administration "is not cutting Medicaid" even as it moves forward with a block grant plan that critics warn would slash benefits for millions of vulnerable people across the nation.
"This is a blatant lie," Rebecca Vallas, senior fellow at the Center for American Progress, tweeted in response to Verma's Washington Post op-ed accusing healthcare activists--including an emergency room doctor who confronted Vice President Mike Pence over the block grant plan last week--of "fearmongering" about Medicaid cuts.
"No," states the headline of Verma's op-ed, "the Trump administration is not cutting Medicaid."
First of all, Vallas tweeted at Verma, "You authorized and are encouraging states to cut off Medicaid for millions who can't meet rigid work reporting requirements." And second, she added, "you're pushing Medicaid block grants, which could strip 14-21 million people of health insurance if enacted nationwide."
As Common Dreams reported last week, the Trump administration unveiled a proposal allowing states to convert federal Medicaid funding into fixed sums, a longstanding conservative goal that critics warn could constrain states' ability to hike spending on the program in response to an increase in public need.
Edwin Park, research professor at the Georgetown Center for Children and Families at Georgetown University's McCourt School, wrote on Twitter that Verma's op-ed includes "many misleading claims" and warned the administration's proposed Medicaid block grants would not keep up with inflation--effectively resulting in cuts in the future.
The House of Representatives, with zero Republican votes, passed a non-binding resolution on Thursday officially condemning the Trump administration's Medicaid block grant plan as an "illegal" and "cruel attack on a program that provides for the health and well-being for some of our most vulnerable citizens."
"The Trump administration should uphold its responsibility to faithfully execute the law, including the Medicaid Act, and cease any and all efforts that threaten the care of the millions of Americans who rely on Medicaid," the resolution stated.
David Dayen, executive editor of The American Prospect, said earlier this week that Democrats should force a vote on the resolution in the Senate to make sure all Republicans in Congress are on the record regarding Trump's attacks on the program:
Block-granting Medicaid has been Republican goal since at least the administration of former President Ronald Reagan. Bruce Bartlett, an architect of Reagan's right-wing economic agenda who has since broken with the GOP, tweeted last month that "block grants are just a Republican trick to slash spending without appearing to do so."
Rob Davidson, executive director of the Committee to Protect Medicare and the physician who confronted Pence at a restaurant in Iowa last month, applauded House Democrats for denouncing the Trump administration's block grant proposal and echoed their demand that the White House "reverse this dangerous action."
"President Trump's latest healthcare cuts will endanger the health, security, and lives of millions of American families," Davidson said in a statement. "Instead of cutting healthcare as President Trump continues to do, we should expand it, protect patients with preexisting conditions, and reduce the astronomical costs of prescription drugs."
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'Cruelty Is the Point': Trump Takes Aim at Medicaid With Plan That Could Harm Millions
"The president's war on healthcare knows no bounds."
Jan 23, 2020
The Trump administration is reportedly planning to intensify its assault on Medicaid by granting certain states permission to convert federal funding for the program into block grants, a move critics slammed as a cruel and likely illegal attack on vulnerable people.
Politico reported Thursday that the plan, which could be finalized as early as next week, would allow the 37 states that expanded Medicaid under the Affordable Care Act to seek waivers to convert funding into fixed sums that could limit states' flexibility to increase spending in response to public need.
Block-granting Medicaid is a longtime Republican goal dating back at least to the Reagan administration. The Trump administration's proposal has been in the works for over a year.
"In the same week President Trump said cuts to Medicare and Medicaid are on the table, we now learn that his administration is set to propose benefit-slashing block grants on Medicaid expansion."
--Brad Woodhouse, Protect Our Care
Bruce Bartlett, an architect of former President Ronald Reagan's right-wing economic agenda who left the GOP in 2006, tweeted Thursday that "block grants are just a Republican trick to slash spending without appearing to do so."
"Money is fungible," Bartlett said. "Medicaid funding will be used to pay for other programs or even to finance tax cuts."
News of the plan, led by Centers for Medicare and Medicaid Services Administrator Seema Verma, comes just days after President Donald Trump threatened to slash Medicare and Social Security funding "at some point" should he win reelection in November.
According to Politico, the specifics of the Medicaid proposal--which the Trump administration is looking to implement without congressional approval--are "in flux, as officials work to identify an alternative to the term 'block grant,' which has negative connotations in the advocacy community."
Brad Woodhouse, executive director of advocacy group Protect Our Care, said in a statement that the administration's latest attack on Medicaid shows "the president's war on healthcare knows no bounds."
"In the same week President Trump said cuts to Medicare and Medicaid are on the table," said Woodhouse, "we now learn that his administration is set to propose benefit-slashing block grants on Medicaid expansion, targeting the benefits of millions of Americans who have gained coverage through one of the Affordable Care Act's most important, successful, and popular provisions."
Kim Nelson, a public health advocate and South Carolina Democratic congressional candidate, tweeted Friday that Medicaid block grants "don't work."
"They can't keep pace with the rising costs of healthcare (even the ones that 'adjust for inflation') and lead to would-be recipients going without care," said Nelson. "Forty-three percent of Medicaid enrollees are children. The Trump admin knows that. The cruelty is the point."
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